Is Obamacare Going to ‘Explode’ as President Trump Predicted?

On Friday, the president said the Affordable Care Act (ACA), also known as Obamacare, was going to “explode.”

He repeated that in a tweet on Saturday.

And on Monday, his press secretary, Sean Spicer, reiterated the expectation, saying Obamacare was “.”

They made the statements in response to the of Republican leaders in the House of Representatives last week to approve a plan to “replace and repeal” Obamacare.

Experts interviewed by Healthline said the ACA may indeed start to unravel later this year.

In part, they said, because Obamacare was headed for trouble anyway.

And it’s also because the Trump administration might not do much to help the healthcare system and, in fact, can do things to help push it over the cliff even sooner.

So, what happens if the ACA does collapse?

“It’s going to be chaos,” Kurt Mosley, vice president of strategic alliances at Merritt Hawkins health consultants, told Healthline. “There has to be some kind of life support for the current system until a new plan is passed.”

Twila Brase, president of the Citizens’ Council for Health Freedom, had a similar but slightly less pessimistic view.

“I think Obamacare as we know it will implode,” Brase told Healthline. “However, that doesn’t mean the health system will implode.”

Will they sabotage?

Obamacare was facing a number of obstacles already this year.

The first was that several large insurance firms, among them UnitedHealthcare, had already significantly cut back on their participation in the state marketplaces that sell health insurance under the auspices of the ACA.

That has left about one-third of the counties in the United States with only one insurer in these marketplaces, according to a .

The ACA system is also having trouble getting younger, healthier people to sign up. The tax penalties imposed on people who don’t have health insurance haven’t been high enough to motivate those younger folks to enroll.

Despite these problems, Ron Pollack, the executive director of Families USA, said Obamacare will remain healthy if it is allowed to move forward unimpeded.

“I think [the implosion] is purely wishful thinking on the part of the president,” Pollack told Healthline.

However, he acknowledged there are a number of things the White House can do to sabotage Obamacare.

“It really is a question of what is the intent of the administration,” said Pollack. “It’s hard not to take [the president’s comments] as a signal.”

One thing the White House has already done is of the tax penalties for people without insurance.

That is likely to encourage even fewer younger, healthier people to sign up. Without their participation, it’s difficult for insurance companies to balance the costs of insuring older participants and less healthy customers.

“Unless young people sign up for this, I don’t see how it works,” said Mosley.

The other thing the White House has already done is not promote the open enrollment periods.

In late January, the Trump administration for Obamacare a couple weeks before this year’s enrollment period ended.

In the end, signed up for insurance plans on healthcare.gov, which serves 39 states. If state-run exchanges are included, Obamacare enrollment rises to 12 million. That’s still about half a million fewer enrollees than last year.

The Trump administration could decide to forgo advertisements for the entire 2018 enrollment period, which begins on Nov. 1.

“There won’t be as much pressure on people to sign up then,” Brase noted.